High Anion Gap Metabolic Acidosis (HAGMA)
| C | Carbon Monoxide, Cyanide |
| A | Alcohol, Alcoholic Ketoacidosis |
| T | Toluene |
| M | Metformin, Methanol |
| U | Uraemia |
| D | Diabetic Ketoacidosis |
| P | Paraldehyde, Phenformin, Paracetamol, Propylene glycol |
| I | Iron, Isoniazid |
| L | Lactic acidosis (any cause) |
| E | Ethylene glycol |
| S | Salicylates |
Causes of Lactic Acidosis
| Type A: Imbalanced oxygen supply and demand | Type B: Metabolic derangements |
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Non-anion Gap Metabolic Acidosis (NAGMA)
| U | Ureteroenterostomy |
| S | Small bowel fistula |
| E | Extra chloride, Normal saline hydration |
| D | Diarrhoea |
| C | Carbonic anhydrase inhibitors (acetozolamide, topiramate…) |
| A | Adrenal insufficiency |
| R | Renal tubular acidosis |
| P | Pancreatic fistula |
Causes of a low anion gap
| Increased cations | Calcium, magnesium, lithium, multiple myeloma |
| Decreased anions | Dilution, hypoalbuminaemia |
| Artefactual | Bromism, Iodism, Propylene glycol, Triglycerides |
Metabolic Alkalosis
| C | Contraction (volume contraction) |
| L | Liquorice, Diuretics (Lasix™) |
| E | Endocrine (Bartter’s, Cushing’s, Conn’s) |
| V | Vomiting, NG suction (Chloride loss) |
| E | Excess alkali (Antacids, Dialysis, Milk-Alkali Syndrome) |
| R | Refeeding alkalosis |
| R | Renal bicarbonate retention (Hypochloraemia, Hypokalaemia, Chronic hypercapnia) |
Respiratory acidosis
| Acute | Chronic |
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Respiratory alkalosis
| C | CNS disease (Raised ICP) |
| H | Hypoxia (Altitude, anaemia, VQ mismatch) |
| A | Anxiety |
| M | Mechanical hyperventilation |
| P | Progesterone, pregnancy |
| S | Sepsis, Salicylates, Other Toxins (nicotine, xanthines) |